Accurate analysis tool and method for the quantitative acoustic assessment of infant cry

ABSTRACT

An automated infant cry analyzer with high accuracy to detect important acoustic features of cry is provided. The system&#39;s accuracy was rigorously tested and was compared to ground truth manual coding. The resulting methods and systems are applied to infant developmental disorders.

RELATED APPLICATIONS

The present application is a continuation of and claims the benefit ofinternational application serial number PCT/US2013/057295 filed Aug. 29,2013, which claims the benefit of U.S. provisional application Ser. No.61/694,437 filed Aug. 29, 2012, and Ser. No. 61/718,384 filed Oct. 25,2012 entitled, “Accurate analysis tool and method for the quantitativeacoustic assessment of infant cry” by Stephen J. Sheinkopf, Barry M.Lester and Harvey F. Silverman, each of which is hereby incorporatedherein by reference in its entirety.

GOVERNMENT SUPPORT

The invention was made with government support under grant number R21DC010925 awarded by the National Institutes of Health. The governmenthas certain rights in the invention.

TECHNICAL FIELD

Apparatus and methods are provided for quantitative acoustic accurateassessment of infant cry.

BACKGROUND

Infants are afflicted with various developmental disorders for exampleautism spectrum disorders, Asperger's syndrome, Down's syndrome,cerebral palsy, velocariofacial syndrome, Klinefelter's syndrome,William's syndrome, Prader-Willi syndrome, Mowat-Wilson syndrome, andneurofibromatosis. Neurodevelopmental disorders in infants impair growthand development of brain or central nervous system producingneurodevelopmental consequences. Early intervention is one of the mostpromising treatments for developmental disorders but requires earlydiagnosis to be most effective.

Acoustic analysis of infant cry has been a focus of clinical anddevelopmental research for a number of years. Although a variety ofapproaches to cry analysis have been employed, each has its drawbacks.Applied and clinical studies of infant cry have examined features of cryproduction that may distinguish babies with specific conditions ormedical risks. Lester et al., utilizes infant cry analysis as a measureof developmental status in babies with pre- and peri-natal risk factors,such as prenatal substance exposure. Lester et al., Pediatrics, 110,1182-1192 (2002). Goberman & Robb, 1999 analyzes infant cry forpremature birth. Goberman, A. M, and Robb, M. P. Journal of Speech,Language and Hearing Research, 42, 850-861 (1999). Sheinkopf et al.,analyzes infant cry for autism. Sheinkopf et. al., Autism Research, 5,331-339 (2012).

In response to a pain stimulus, the cry acoustics for an infant at riskfor autism is atypical and high-pitched. Ibid., p 6 ¶ 2.

Manual inspection of spectrograms is the standard method for detectingacoustic features in cry sounds, including the timing and onset of cryvocalizations and, the fundamental frequency of cry. However, the manualinspection method is slow, limiting the amount of data that can beanalyzed and requires trained observers to visually inspect thespectrograms. There is a need for a non-invasive, fast, automatic andaccurate test for diagnosing infant developmental disorders, yieldingearly detection and a capability of early intervention in treatment ofthe developmental disorders.

SUMMARY

The invention provides a method and an apparatus for analysis of infantcry to robustly and accurately identify features thereof. Identifiedfeatures may form a record printout, and atypical features can becorrelated with a diagnosis made by conventional means at a later time(e.g., in childhood, post-verbal) to develop a measure or table ofdiagnostic indicia, and/or features may be compared to a known list ortable of known or suspected condition-indicating atypical featuresassociated with specific medical, developmental, disease or injuryconditions. The method and apparatus may be automated for easyapplication to an infant, and may be applied to selected at-risk infantsfor earlier detection and, where appropriate, intervention. It may alsobe applied to confirm or refine a diagnosis, or to follow progression ofa condition. Advantageously, the apparatus may be set up to receive,make or operate upon a digital recording in an industry standard format,such as a 48,000 sample-per-second (48 ks/s) 16-bit recording format ofa consumer device, and to quickly and automatically derive the resultantfeatures and measures. When used as a standardized clinical instrumentproviding a defined stimulus and controlled recording, the processedrecords offer greater sensitivity, accuracy and the ability to identifydiagnostic features present in short sound records and to identify newanomalies or indicia not otherwise apparent even to an experiencedclinician or technician.

An aspect of the invention herein provides a method for analyzing infantcry, the method including

-   -   filtering a digital recording of an infant cry, by assigning to        a digital signal of the recording: a fixed frame rate of a        plurality of samples, a window function, and a frame advance,        thereby obtaining an altered digital signal, and limiting a        range of accepted frequency by applying a frequency window to a        log-spectrum of the altered digital signal, such that the        frequency window is from about 200 Hz to about 2200 Hz, and in        this way obtaining a first filtered digital signal, so that the        first filtered digital signal is a frequency window output;    -   estimating a fundamental frequency (F₀) and a cepstrum value of        the infant cry by applying to the first filtered digital signal        an inverse Discrete Fourier Transform to obtain the fundamental        frequency and cepstrum estimate value of the first filtered        digital signal, and in this way obtaining a second filtered        digital signal;    -   smoothing the second filtered digital signal by applying a        programming smoother to the second filtered digital signal and        maintaining continuity in the fundamental frequency estimates of        the second filtered digital signal, eliminating outliers from        the second filtered digital signal by applying a median filter,        such that the median filter is selected from a group of a median        filters of five point and seven point median filters, to the        second filtered digital signal and obtaining a median output,        extracting a confidence measure from at least one of the first        filtered digital signal values and the second filtered digital        signal on a frame by frame basis, and applying to the median        output a signal-to-noise ratio test, and in this way obtaining        at least one parameter of acoustic analysis of the infant cry.

An embodiment of the method further includes estimating the fundamentalfrequency of the first filtered digital signal, if greater than about800 Hz, by applying an interpolated transform of 4096 points and a lowpass filter.

An embodiment of the method further includes, after applying the signalto noise ratio test, classifying a sound segment of the infant crywithin the parameters as at least one of: an utterance, a shortutterance, and a silence, such that the sound segment comprises a groupof frames having similar properties.

An embodiment of the method further includes characterizing a soundsegment record by each of elements: classifier output, timingparameters, F₀ parameters, hyper-pitch parameters, formant parameters,parameters from fitting a polynomial to the pitch contour, andparameters for amplitudes from several octave frequency bands.

In an embodiment of the method the parameter of acoustic analysisincludes at least one of: frame number, time (ms), F₀, F₀ amplitude(dB), F₀ confidence [0-1], Hyper-pitch (Hz) ([1-5] kHz range),Hyper-pitch amplitude (dB), Hyper-pitch confidence [0-1], Peak pitchamplitude (dB), Overall amplitude (dB), Amplitude [0.5-10] kHz (dB),Amplitude [0-0.5] kHz (dB), Amplitude [0.5-1] kHz (dB), Amplitude[1-2.5] kHz (dB), Amplitude [2.5-5] kHz (dB), Amplitude [5-10] kHz (dB),F₁ (Hz), Amplitude of F₁ (dB), F₂ (Hz), Amplitude of F₂ (dB), F₃ (Hz),and amplitude of F₃ (dB).

An embodiment of the method further includes, prior to filtering thedigital recording, converting the digital recording into a computerreadable format by a computer program embedded in a non-transitorycomputer readable medium.

In an embodiment of the method, the utterance has a signal length equalto or greater than 0.5 s.

An embodiment of the method further includes estimating the fundamentalfrequency of the infant cry further comprises validating, such that theestimate has an accuracy of at least about 80%, about 85%, about 90%,about 95%, or at least about 99%.

In an embodiment of the method, the computer readable format is a .csvfile of values of the parameters of acoustic analysis.

An embodiment of the method further includes obtaining at least oneparameter from normal infant subjects, and from infants having adevelopmental disorder or at risk for having a developmental disorder.

In an embodiment of the method, the developmental disorder is selectedfrom the group of: Autism Spectrum Disorders selected from the group of:Autistic Disorder, Asperger's Disorder, Child Disintegrative Disorder,Retts Disorder, Pervasive Developmental Disorder NOS, and AutismSpectrum Disorder; Communication Disorders selected from the group of:developmental language disorders, Mixed Expressive-Receptive LanguageDisorder, Language Disorder, Speech Disorder, and Social CommunicationDisorder; Intellectual Developmental Disorders selected from the groupof: Intellectual Developmental Disorder and Intellectual or GlobalDevelopmental Delay Not Elsewhere Classified; hearing impairment;cognitive impairment; language impairment; behavior disorders; andimpairments or deficits related to “high risk” conditions exemplified byprenatal substance exposure, prematurity, low birthweight, intrauterinegrowth retardation, medical illness or brain injury, maternal history ofmental illness, treatment, adverse pregnancy conditions exemplified bypoor nutrition, poor prenatal care, physical assault, and geneticconditions that increase risk for cognitive, language, or behavioralimpairments. An embodiment of the method further includes, afterobtaining the digital recording of the infant cry, classifying oridentifying a portion of infants that have the disorder from among aplurality of infants.

An embodiment of the method further includes, after obtaining thedigital recording of the infant cry classifying retrospectively theportion of infants having the disorder, for example, the developmentaldisorder. A database of infant cries has been compiled including thecries of infants exposed to substance abuse, at risk of developmentaldisorders, etc., so that the retrospective analysis can be carried outto identify several distinguishing parameters so that prospectivecorrections are possible.

An embodiment of the method further includes, applying a pain stimulusto an infant, so that the pain stimulus stimulates the infant cry inreaction.

In an embodiment of the method, the infant cry is stimulated by applyinga pain stimulus.

In an alternative embodiment of the method, the infant cry isspontaneous.

In an embodiment of the method, the method distinguishes a pain inducedcry and a spontaneous cry.

An aspect of the invention herein provides an apparatus for analyzing aninfant cry, the apparatus having the components,

-   -   a recording device to record the infant cry, and so obtaining a        digital signal of a recorded infant cry,    -   a computer program embedded in a non-transitory computer        readable medium to convert the digital signal of the recorded        infant cry into a computer readable format, such that the        computer program includes filtering the digital signal,        estimating a fundamental frequency and a cepstrum value,        smoothing the digital signal, eliminating outliers, extracting a        confidence measure and applying a signal to noise ratio to the        digital signal, and so obtaining a computer readable file, such        that the computer readable file comprises at least one parameter        of acoustic analysis of the recorded infant cry, and    -   a computer, such that the recording device and the        non-transitory computer readable medium are compatible with the        computer and are linkable to the computer.

In an embodiment of the apparatus the parameter of acoustic analysisincludes at least one of: frame number, time (ms), F₀, F₀ amplitude(dB), F₀ confidence [0-1], Hyper-pitch (Hz) ([1-5] kHz range),Hyper-pitch amplitude (dB), Hyper-pitch confidence [0-1], Peak pitchamplitude (dB), Overall amplitude (dB), Amplitude [0.5-10] kHz (dB),Amplitude [0-0.5] kHz (dB), Amplitude [0.5-1] kHz (dB), Amplitude[1-2.5] kHz (dB), Amplitude [2.5-5] kHz (dB), Amplitude [5-10] kHz (dB),F₁ (Hz), Amplitude of F₁ (dB), F₂ (Hz), Amplitude of F₂ (dB), F₃ (Hz),and amplitude of F₃ (dB).

In an embodiment of the apparatus, the computer readable format is a.csv file of values of the parameters of acoustic analysis.

In an embodiment of the apparatus, the recording device is a stand-alonedevice and the digital signal of the recorded infant cry from therecording device applied to the computer.

In an embodiment of the apparatus, the detection of the fundamentalfrequency of the infant cry further includes validating, wherein theestimate has an accuracy of at least about 80%, about 85%, about 90%,about 95%, or at least about 99%.

An embodiment of the apparatus further includes a stimulating component,wherein the stimulating component provides a pain stimulus to an infantand generates the infant cry in reaction.

In an embodiment of the apparatus, the recording device is a handhelddevice.

In an embodiment of the apparatus, the recording device is a mountabledevice, and is mounted adjacent to the infant to record the infant cry.

An aspect of the invention herein provides a device for stimulating painin a subject and calibrating analysis of a pained utterance, the devicehaving the components

-   -   a striking arm, rotationally and movably attached to a platform,    -   an intensity controller, mounted on the platform and digitally        controlling intensity and propulsion of movement of the striking        arm, and    -   an initiating controller, such that the initiating controller is        mounted on the platform and initiates a striking motion of the        striking arm upon activation.

An embodiment of the device further includes an initiation signalcoordinated with activation of the striking arm thus standardizingextent of stimulus and timing of a recording of a resultant utterance bythe subject.

In an embodiment of the device, the initiation signal is emitted inaudio range and includes a specific function for accurate time locationsuch as a chirp and a frequency encoded coda containing information onstrength of stimulus.

In an embodiment of the device, the device for stimulating pain islinked to a computer, wherein an activation of the striking motion ofthe striking arm is controlled by the computer.

An aspect of the invention herein provides an apparatus for infant cryanalysis having the components of,

-   -   means for receiving a digital sound recording or digitizing an        analog sound recording of an infant cry, such that the sound        recording is a consumer-device-formatted sound recording or        other standard format,    -   limiting the recording to a frequency range of about 200-2200 Hz        representing a frequency band of interest and segmenting the        recording into cry segments by type, such that the segment types        include intervals of silence, short cries and long cries,    -   performing computerized acoustic analysis on each segment to        identify acoustic parameters of the recording, wherein the        acoustic parameters include one or more of frame number, time        (ms), F₀, F₀ amplitude (dB), F₀ confidence [0-1], Hyper-pitch        (Hz) ([1-5] kHz range), Hyper-pitch amplitude (dB), Hyper-pitch        confidence [0-1], Peak pitch amplitude (dB), Overall amplitude        (dB), Amplitude [0.5-10] kHz (dB), Amplitude [0-0.5] kHz (dB),        Amplitude [0.5-1] kHz (dB), Amplitude [1-2.5] kHz (dB),        Amplitude [2.5-5] kHz (dB), Amplitude [5-10] kHz (dB), F₁ (Hz),        Amplitude of F₁ (dB), F₂ (Hz), Amplitude of F₂ (dB), F₃ (Hz),        and amplitude of F₃ (dB), and    -   providing the detected parameters as a spreadsheet file for use        as a validated medical or diagnostic record.

An embodiment of the apparatus further includes diagnostic software forhighlighting diagnostic indicia among the reported parameters, such thatthe diagnostic indicia reflect likelihood that the infant cry indicatesa developmental or neurological condition such as ASD, or a medicalcondition such as an airway or tissue anomaly.

An embodiment of the apparatus further includes a cry stimulus devicefor providing a controlled pain stimulus to an infant synchronized withrecording of the infant's cry, and optionally further with a videorecorder for validating cry data.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features of the invention will be understood from thedescription herein and the claims appended hereto, taken together withillustrative figures, wherein

FIG. 1A shows an example of a voiced infant-cry spectrum, FIG. 1B showsa non-windowed cepstrum of same frame showing range for inspecting forrahmonics (the term “rahmonic” refers to harmonics in the cepstraldomain), and FIG. 1C shows a windowed cepstrum showing range forinspecting rahmonics;

FIG. 2 shows an example of the spectrum of a hyper-pitch-excited frameand the cues from the peaks;

FIGS. 3A and 3B show an example of the smoothed function fordetermination of formant positions, evidencing is strong influence fromthe harmonics of F₀;

FIG. 4 illustrates a spectrogram plot hand-labeled to establish groundtruth for voicing type; intervals were labeled as voiced (V), unvoiced(UV), silence (S), voiced-fricative (VF), or high-voicing (HV);

FIG. 5A shows Receiver Operating Characteristic (ROC) Curve showingagreement between ground-truth hand-labeling and manual hand-labeling ofabout 10% of data used in the validation; FIG. 5B shows an expandedgraph of the dotted area of FIG. 5A;

FIG. 6A shows the Percentage of the 2,915 voiced frames with correctpitch-frequency estimates (|f−F₀|≤T) for several error tolerances (T, inHz), and FIG. 6B is an expanded graph of the dotted area of FIG. 6A;

FIG. 7 shows ROC curves giving the voicing-detection performance of thesystem. Voiced (V), voiced-fricative (VF), and high-voiced (HV) frameswere separately considered to be positives. In each case, both unvoiced(UV) and silence (S) frames were considered to be negatives. Area underthe curve (Az) values were: V/(UV,S)=0.997; HV/(UV,S)=0.907;VF/(UV,S)=0.995.

DETAILED DESCRIPTION

Methods and results including working examples are found in the AppendixA (46 pages) of the United States provisional patent applications whichare priority documents for this International Application, a thenunpublished manuscript entitled “A Flexible Analysis Tool for theQuantitative Acoustic Assessment of Infant Cry”, authors BrianReggiannini, Stephen J. Sheinkopf, Harvey F. Silverman, Xiaoxue Li, andBarry M. Lester, and submitted to Journal of Speech, Language, andHearing Research, and currently available online as Journal of Speech,Language and Hearing Research 2013: doi:10.1044/1092-4388(2013/11-0298)hereby incorporated by reference in its entirety herein. Briefly asdescribed therein a versatile, sensitive and accurate method andapparatus for infant cry analysis is described together with its use tomeasure, detect and quantify cry features of clinical interest.

Methods and Apparatus: System Description and Approach

The acoustic analyzer herein described was specifically designed andconfigured for infant-cry analysis, utilizing signal processingalgorithms arranged to extract acoustic parameters describing infantcries from standard digital audio files. The analysis device uses aframe rate of 25 ms with a frame advance of 12.5 ms and appliesCepstral-based acoustic analysis, and it proceeds in two phases,computing frame-level data and then organizing and summarizing thisinformation within cry utterances. The system was automated to detectfeatures of interest under controlled or accurate recording conditions,for features which were known or suspected to be diagnostic indicators.

Accuracy of the automated system was evaluated by comparingdeterminations of voicing and fundamental frequency (F₀) to voicedsegments and pitch periods manually coded from spectrogram displays. Thesystem was found to detect F₀ with 88% to 95% accuracy, depending ontolerances set at 10 Hz to 20 Hz, and Receiver Operating Characteristic(ROC) analyses demonstrated very high accuracy at detecting voicingcharacteristics in the cry samples. The digitized signal processing ofthe automated infant cry analyzer provides high sensitivity and accuracyfor detection of important acoustic features of infant cry, as well asidentification of new features or significant combinations of suchfeatures in known populations. A unique and important aspect of thiswork is the rigorous testing of the system's accuracy as compared toground truth manual coding. The analyzer system has many implicationsfor basic and applied research on infant cry development, includingembodiment in instruments, early in-clinic detection of conditions,confirming, diagnosing or tracking development or changes in conditions,and preparation of objective medical records for subject files.

Processing in the cry analysis tool utilizes robust methods for voicingdetermination along with a cepstral analysis for the detection andtracking of F₀. Investigating the validity of automated acousticassessment of cry can be thought of as studying the sensitivity andspecificity of an automated method of detecting the signal periodicitythat constitutes F₀. The tool extracts acoustic information fromdigitally recorded infant cries. The sensitivity and specificity of theautomated system to detect F₀ (pitch periods) is automatic and fast, andcompares favorably to the pitch periods manually coded by a trainedobserver from a sound spectrogram (oscilloscope view). Additionalprocessing may categorize voiced versus typically short, unvoicedutterances, or segments of utterances that are unvoiced. This includes aquantification of the confidence of the voicing determination, which canbe adapted by researchers depending on the scientific questions beingaddressed. The detailed output from this system can be easily subjectedto statistical analysis for hypothesis testing. This system is detailedand flexible enough to allow researchers to describe infant cries at theutterance level, while also producing detailed frame-by-frame acousticoutput.

Scope of input data and the signal processing stages were determinedbased upon the range of measures or outputs to be examined, basing thislist on prior cry analysis work. These included parameters tocharacterize F₀, amplitude or energy of cry, timing variables (latency,onset, duration, inter-utterance interval, etc.) and formants (whileacknowledging difficulty in measurement). In addition to the kinds ofvariables used in prior automated analyses, a further aim was to use F₀tracking to model the shape or contour of F₀ across each cry utterancein a cry episode. This may be analogized to “cry melody” in some pastresearch, such Wermke, Leising, and Stellzig-Eisenhauer (2007) citedabove, where F₀ was characterized as rising then falling, or havingother contours across a cry utterance.

The complex interplay of neural, physiological and anatomical factorsmanifested in the properties of the driving function of the cry wasconsidered, notably, periodicity of the glottal motions which determineproperties such as the pitch or the amount of voicing-excited turbulencein a cry. The shape of the vocal tract determines the resonantfrequencies (formants) of the spectrum of the cry at a given instant.Important acoustic properties of infant cry include F₀, defined as thefundamental frequency of the glottal excitation (vibrations of the vocalfolds), and the formant frequencies, defined as resonances of the vocaltract. In other or further systems, non-vocal-fold driven turbulencesneed also to be detected and categorized in a suitable analysis system.

Processing in the proof-of-principle system is run as two sequentialprograms: Phase I analyzes the digitized data to produce a set ofparameters for each consecutive 12.5 ms frame. Phase II takes the PhaseI output as input and produces an output record for each consecutivegroup of frames that has similar properties. The analysis tool iscurrently implemented in MATLAB®, but is easily adaptable for anyembedded processor. The analyzer assumes the standard 16-bit, 48 ks/sdigital (768 kbits/s) .wav file of a consumer or professional digitalsound recorder as the cry recording upon which it operates. Thesesampling and quantization parameters are sufficiently high to ensurethat all cues are captured and that there is sufficient headroom fordynamic range differences. In this study, we have recorded cry samplesusing an Olympus DM-520 digital voice recorder (Olympus Imaging America,Inc., Center Valley, Pa.). This standardized input format can easily bereplicated in other studies, and the system processing may be carriedout in a suitably programmed general purpose computer, or in acustomized device adapted to receive and process the digital recording.

Phase I of the processing takes the .wav files and produces acomma-separated value (CSV) file that is not only readable by the PhaseII program but also by programs such as Microsoft Excel. In the firstphase of the analysis system, all outputs relate to the unit of a fixedlength, fixed-advance frame described by 22 numerical parameters. Thus,as each number has a 32-bit representation, this implies a data rate ofonly 56.32 kbits/s, a significant reduction. The first two lines of eachPhase I output file are headers. The fields for the header record aredefined in TABLE 1.

TABLE 1 Initial header record definitions 1: Phase I or Phase II (text)2: Subject (text) 3: Subject description (text) 4: Number of zero frames5: Mean value of recording [0, 32767] 6: 1% Dynamic range [0, 32767] 7:1% Dynamic range (dB) 8: 5% Dynamic range [0, 32767] 9: 5% Dynamic range(dB) 10: 10% Dynamic range [0, 32767] 11: 10% Dynamic range (dB) 12:Quality classOne area addressed by the system is that there are many useful (older)infant-cry samples that have been recorded on analog tape. However,recording quality of these tapes may vary. Thus a preliminary automaticscan of a digitized recording has been designed to ascertain arecording's quality, based on background noise—usually hum andsignal-to-noise ratio (as determined by an average amplitude forhigh-energy events to the amplitude of easily identifiable “silence”regions)—and a detection of saturation at some phase of the recordingprocess. The mean value of the recording, an estimate of the dynamicrange, and a classification of the quality of the file (high-quality,noisy, low-level, analog saturated, digital saturated) are all put intothe header file for the Phase I system.

The rest of the output file consists of fixed-length records, one recordper frame, as defined in TABLE 2. A fixed frame rate of 1200 samples (25ms) was used with a frame advance of 600 samples (12.5 ms) to keepreasonably high resolution in both time and frequency. The analysissystem was designed to be liberal with its use of computation so as toreflect resultant parameters more accurately. Thus three discreteFourier transforms are computed for each 1200-point frame. The middle768 points are transformed for the F₀ estimate as explained below. Thefull frame (1200 points) is transformed for amplitude computations andan interpolated transform of 4096 points (1448 zeros, the 1200 pointframe and 1448 zeros) is used to detect F₀ above 1 kHz (what we termhyper-pitch).

TABLE 2 Phase I: Definition of fields of per frame record 1: Framenumber 2: Time(ms) 3: F₀(Hz) 4: F₀ amplitude(dB) 5: F₀ confidence [0, 1]6: Hyper-pitch(Hz) ([1, 5]kHz range) 7: Hyper-pitch amplitude(dB) 8:Hyper-pitch confidence [0, 1] 9: Peak pitch amplitude(dB) 10: Overallamplitude(dB) 11: Amplitude[0.5, 10]kHz(dB) 12: Amplitude[0, 0.5]kHz(dB)13: Amplitude[0.5, 1]kHz(dB) 14: Amplitude[1, 2.5]kHz(dB) 15:Amplitude[2.5, 5]kHz(dB) 16: Amplitude[5, 10]kHz(dB) 17: F₁(Hz) 18:Amplitude of F₁(dB) 19: F₂(Hz) 20: Amplitude of F₂(dB) 21: F₃(Hz) 22:Amplitude of F₃(dB)

The Phase II program takes the Phase I data as input and reduces thedata further, separating it into groups of frames having similarproperties, which we call sound segments. The CSV output has a recordfor each of these groups of frames. The concatenated groups of framesare labeled to be one of the following classes:

-   -   1. silence    -   2. short utterances (length<0.5 s, relatively high energy)    -   3. long utterances (length>0.5 s, high energy)        The output from Phase II contains information summarizing        utterance-level characteristics of infant cries, and thus the        Phase II output is expected to be most useful for studies of        crying in various infant populations. Phase I accuracy has been        carefully tested because the validity of the summary output        rests upon this phase.        The Phase I System

There are several approaches that could be used for pitch detection, andthe more common of these methods are based on:

1) time-event rate detection (Ananthapadmanabha & Yegnanarayana, 1975;Rader, 1964; Smith, 1954, 1957);

2) auto-correlation methods (Dubnowski, Schafer, & Rabiner, 1976; Gill,1959; Rabiner, 1977; Stone & White, 1963); and

3) frequency domain methods.

Time-event rate detection methods are based on the fact that if an eventis periodic, then there are extractable time-repeating events that canbe counted and the number of these events per second is inverselyrelated to the frequency. Auto-correlation methods are used as a measureof the consistency or sameness of a signal with itself at different timedelays; the peak of the time-delay value is returned as the pitchperiod. Finally, frequency domain approaches include methods such ascomb filters (filters in which a signal is subtracted from itself atdifferent time delay values) (Martin, 1981), tunable infinite impulseresponse (IIR) filters (Baronin & Kushtuev, 1971), and cepstrum analysis(Bogert, Healy, & Tukey, 1963; Noll, 1967).

The time-event rate detection methods are extremely simple and easy toimplement. However, they have immense difficulties dealing withspectrally complex signals such as human speech or a baby's cry. Theautocorrelation and the first two frequency domain methods are also moresuitable for cleaner signals (e.g., sounds produced by musicalinstruments). Perhaps the method most widely used for obtaining F₀ inadult speech is cepstrum analysis. When applied correctly, it has provento be a robust method for describing acoustic properties of non-infantvocalizations, and if suitable for the complex vocalic signals of infantcry, would be useful; the resulting cepstral coefficients are thestandard features for speech recognition algorithms. We selectedcepstrum analysis to develop the cry analysis algorithm in this project.

It is accepted that a normal infant cry F₀-range is 200 Hz to 1 kHz or apitch period range of 5 ms to 1 ms. As pitch-period estimates areobtained using a modified version of the cepstrum method (Noll, 1967),several pitch periods are required within each frame to make the shorttime frame appear periodic. Thus, to get a minimum of three pitchperiods (and a reasonable number for applying a fast Fourier transformof FFT) we selected a fixed frame of 768 points (or 16 ms for 48 kHzsampling) of each 1200-point frame and a 768-point Hamming window. Alarger window will cause the cepstral pitch peak to broaden for thehigher F₀ values, and a smaller window will not have as good cepstralpeaks for low values of F₀. The Hamming window will broaden the harmonicpeaks, but eliminate most the effects due to sidelobe accumulations.This analysis strategy was decided upon in order to capture 4 to 8 pitchperiods per frame.

Given the nature of infant cry, greater frame lengths would decrease thereliability of pitch-period estimation. Thus, we had to modify the basictechnique in order to compensate for the unique characteristics ofinfant cry. The first change was to apply a frequency window W [r],effectively limiting the band to be considered to be from 200 Hz to 2200Hz, to the log-spectrum before computing the inverse DFT. Because energyin voiced speech naturally falls off after 4 kHz, the spectral harmonicstructure is amplitude modulated by the rolloff function, which cancause multiple peaks in the cepstrum when the sampling rate exceeds 8kHz. Applying a frequency window smoothes the cepstrum, eliminatingthese modulation effects. The window also deemphasizes low- andhigh-frequency noise. The effects of the frequency window are depictedin FIG. 1C in which the pitch period is easy to identify, although asecond rahmonic is also evident.

We note that infants generally do not double or halve their pitchfrequency nearly instantaneously, during voiced portions of a cryvocalization. Thus, by considering multiple frames at once, many F₀doubling and halving estimation errors can be eliminated. We considerhalving and doubling “errors’ to be those that occur for one or twoframes, which would imply very rapid changes in pitch frequency. It isthese that we try to eliminate, not the longer doubling or halvingregions that appear when even or odd harmonics disappear in thespectrogram. A dynamic-programming smoother is a reasonable mechanism toensure continuity in the F₀ estimates at transitions and many otheranomalies. This is not a new idea (Secrest & Doddington, 1982), but herethe implementation is specifically set-up for infant cries. In ourimplementation, 50-frame blocks (0.625 s) are run through thedynamic-programming algorithm after determining F₀ and a confidencemeasure for independent frames. The last 50 frames of the recorded cryconstitute the last block. As the number of frames is not likely to bedivisible by 50, there is some special processing due to overlap for thelast block. All negative cepstral values are truncated to zero and theaccumulated path metric is simply the sum of the 50 cepstral valuesbuilt in the normal forward part of the dynamic-programming algorithm.The pitch period is allowed to change no more than plus or minus 20cepstral points (0.416 ms) per frame. The backtracked path is used forthe initial estimates for F₀. Following the dynamic programming, somefurther outliers (typically at utterance transitions) are eliminatedusing a standard 5-point median filter. The result is pitch periodestimate q₀[i] for frame i, and pitch frequency (Data element 3 in TABLE2 above) is simply F₀[i]=f_(s)/q₀[i].

Data element 4, pitch energy, is the cepstral value of q₀[i], C[q₀[i],i].

Instead of using amplitude alone, the pitch estimation system is alsowell suited for making voicing decisions for each frame. Data element 5in Table 2 is a pseudo-probability for voicing based on the cepstralanalysis. For cepstrum C[q, i] and pitch-period estimate q₀[i], thetraditional cepstrum method uses C[q₀[i]] as a measure of voicing. Thismeasure will fluctuate under different noise conditions, making itdifficult to find a reliable threshold for a multi-environment system.Instead, we use a signal-to-noise ratio (SNR)-like measure to make avoicing decision. This measure is based on the height of the cepstralpeak with respect to the cepstrum noise level. The window W[r]effectively smoothes the cepstrum of length N by a factor of D, where:

$\begin{matrix}{D \equiv \frac{N}{\sum_{r = 0}^{N - 1}{W\lbrack r\rbrack}}} & (1)\end{matrix}$This smoothing causes peaks in the cepstrum to have a width ofapproximately D+1 samples. This information is used to compute thevoicing confidence measure V which is a function of C[q₀[i], i] and itssurrounding. The cepstrum method searches for evidence of periodicitywithin a finite pitch-period range based on knowledge of human F₀production. In this method, q_(min) and q_(max) are the minimum andmaximum pitch-period (quefrency) indices in the search region. These arefixed and do not vary with the frame index i. The voicing-detectionalgorithm begins by zeroing out all negative C[q] values and all valuesoutside the region q∈[q_(min), q_(max)] in the cepstrum C[q, i]. Thisnon-negative cepstrum is denoted as Ĉ[q, i], and let {circumflex over(D)}=% D &. Pitch-period estimate q₀[i] is chosen to correspond to themaximum value of Ĉ[q, i], as is done in the traditional method.Then, the voicing confidence V[q₀[i], i] is defined as,

$\begin{matrix}{{V\left\lbrack {{q_{0}\lbrack i\rbrack},i} \right\rbrack} = \frac{\sum_{r = 1}^{R}{\sum_{i = \hat{D}}^{\hat{D}}\left( {\hat{C}\left\lbrack {{r \cdot {q_{0}\lbrack i\rbrack}},i} \right\rbrack} \right)^{2}}}{\sum_{j = q_{\min}}^{q_{\max}}\left( {\hat{C}\left\lbrack {j,1} \right\rbrack} \right)^{2}}} & (2)\end{matrix}$where R is the number of rahmonics to include. It was found that R=3 wassufficient, as larger rahmonics were often insignificantly small.

V[q₀[i], i] is a number between 0 and 1. Values of V[q₀[i], i]corresponding to high-quefrency (low-frequency) pitch-period estimatestend to have smaller magnitudes because fewer rahmonics fall within thesearch interval [q_(min), q_(max)]. The decision threshold, α[q₀[i]],depends linearly (from 0.7 at q_(min) to 0.5 at q_(max)) on the index ofthe current pitch-period estimate q₀[i]. In the Phase II program a framewould be labeled as voiced if V[q₀[i], i]≥α [q₀] perhaps along with someamplitude criteria.

$\begin{matrix}{{\alpha\left\lbrack q_{0} \right\rbrack} \equiv {{\frac{0.2}{q_{\max} - q_{\min}}\left( {q_{\min} - q_{0}} \right)} + 0.7}} & (3)\end{matrix}$In addition to being more robust to different noise conditions, V[q₀[i], i] also protects against doubling errors by including themagnitude of cepstral content away from the peak. Although doublingerrors will not be corrected by using this method, it was ultimatelyfound that ignoring such difficult frames by labeling them unvoiced wassufficient for the task at hand.

One potentially significant mode in an infant's cry is when thefundamental frequency is above 1000 Hz, which we call hyper-pitch(Golub, 1989; LaGasse et al., 2005). The method herein thus attempts todetermine a set of hyper-pitch values for each frame. This is done usinga Hamming-windowed 4096-point DFT with the full 1200-point frame data inthe center of inserted zeros to compute an interpolated spectrum, andsearch its log-magnitude for peaks in the range from 1000 Hz to 5000 Hz.The highest peak P[1] in the range is found first and, as the lowesthyper-pitch is 1000 Hz, the spectrum is masked from max[1000, P[1,i]−1000] to min[5000, P[1, i]+1000] and searched for another peak. Thisprocess is repeated until three such peaks have been found P[k, i],where k denotes the individual elements of the set of three peaks (kε[1,3]). The set is then reordered to be left-to-right as {circumflex over(P)}[k, i]. It is hypothesized that the three peaks form some harmonicset and the frequency differences are taken yielding a hyper-pitch valueF_(hp)[i]=0.5({circumflex over (P)}[3,i]−{circumflex over (P)}[1, i]).If only two peaks can be found, then F_(hp)[i]={circumflex over (P)}[2,i]−{circumflex over (P)}[1, i]. There is a special case when thehyper-pitch is about 1000 Hz and the odd harmonics dominate. In thiscase, the minimum difference between peaks is taken as the hyper-pitchfrequency. An example of a spectrum for a frame driven by hyper-pitch isshown in FIG. 2.

The hyper-pitch energy (seventh value in the record) is simply taken asthe average of the fundamental hyper-pitch value and two of itsharmonics. It is not necessarily that of the average of the peaks. Thehyper-pitch confidence (eighth value in the record) is determined in asimilar fashion to that of the confidence in the normal pitch range. Itis a number between zero and one that correlates well with the validityof the hyper-pitch condition being active in the frame. For this resultthe power, A,—not the log power—is accumulated for the range 1000Hz→5000 Hz and the power in the detected peaks, B, (up to four in therange) is also accumulated. The power for a given peak is accumulatedover about 30 interpolated points or about 360 Hz about the peak. Theratio B/A is the confidence measure.

Fields 10 to 16 of the record give the amplitudes in dB for the entireband and for the six sub-bands listed above. The full Hamming-windowed1200-point DFT output is used to accumulate the power in each prescribedband (and overall). Those values are directly converted to dB withoutany normalization. Thus no information is lost, but differences inrecording levels, distance from the microphone, and other aspects ofsound acquisition will also affect these data. However, keepingun-normalized data allows the Phase II system to consider the recordingconditions when making its decisions.

As noted, the determination of formants is a very difficult problem forinfant cries due to the high pitch of the cries and thus the sparseharmonics. Formant positions can be estimated, but their precise centralvalues, if somewhat distant from a pitch harmonic, may be hard toobtain. To estimate formants as accurately as possible, we use theinterpolated 4096-point DFT data. After obtaining the log-magnitudespectral data, we apply a low pass “lifter” to the data whose parametersdepend upon the pitch value. Then substantial peaks in the smoothed dataare taken for the formant positions and the heights of the peaks aretaken for the magnitudes.

FIGS. 3A and 3B show a typical voiced frame. In FIG. 3A the smoothedspectrum is shown while in FIG. 3B the unsmoothed spectrum is given. Theformant positions and their magnitudes take up the last six positions ineach record. One should note that the third formant is more arbitrarythan the first two.

Phase II

The Phase II stage of the analyzer is here described briefly. Phase IIoutput starts with two header records, the first being the same one asthe Phase I header with the first field changed to read “Phase II”. Thesecond contains 81 Phase II column headings. Specific definitions of thefields appear in TABLE 5.

TABLE 5 Phase II: Definition of fields of per-utterance record 1: Filename 2: Start Frame 3: End Frame 4: Length(frames) 5: Length(ms) 6:Class label 7: Time from prev. utt.(ms) 8: # short Utt between utt 9: #frames with no F₀ 10: # voiced fric. frames 11: Frac. voiced fric frames12: Classify “1” if voiced fric. > 60% 13: Start frame of longest voicedfric. 14: End frame of longest voiced fric. 15: # frames with F₀ 16:Avg. F₀(Hz) 17: Max. F₀(Hz) 18: Min. F₀(Hz) 19: STD of F₀ (Hz) 20: #Hyper-pitch Frames 21: Avg. Hyper-pitch 22: Max hyper-pitch 23: Minhyper-pitch 24: STD of hyper-pitch 25: Avg. F₀ peak val 26: Avg.hyper-pitch peak val 27: Avg. F₁(Hz) 28: Max of F₁(dB) 29: Min of F₁(dB)30: STD F₁ (Hz) 31: Avg. F₂(Hz) 32: Max F₂(Hz) 33: Min. F₂(Hz) 34: STDF₂ (Hz) 35: Avg. F₃(Hz) 36: Max. F₃(Hz) 37: Min. F₃(Hz) 38: STD F₃ (Hz)39: Opt. polyfit order 40: Real order of polyfit 41: Polyfit coeff oforder 0 42: Polyfit coeff of order 1 43: Polyfit coeff of order 2 44:Polyfit coeff of order 3 45: Polyfit coeff of order 4 46: Polyfit Coeffof order 5 47: Max of polyfit (fract of utt time) 48: Max of polyfit(Hz) 49: Min of polyfit (fract of utt time) 50: Min of polyfit (Hz) 51:Polyfit class(see Table 5) 52: Class = ‘1’ if final “ripple” 53: Err.polyfit 54: Avg Amplitude(dB) 55: Peak Amplitude(dB) 56: Min.Amplitude(dB) 57: STD Amplitude(dB) 58: Avg Amp [0.5, 10]kHz (dB) 59:Peak Amp [0.5, 10]kHz(dB) 60: Min Amp [0.5, 10]kHz(dB) 61: STD Amp [0.5,10]kHz(dB) 62: Avg Amp[0, 0.5]kHz(dB) 63: Peak amp [0, 0.5]kHz(dB) 64:Min Amp [0, 0.5]kHz(dB) 65: STD Amp [0, 0.5]kHz(dB) 66: Avg Amp [0.5,1]kHz(dB) 67: Peak Amp [0.5, 1]kHz(dB) 68: Min Amp [0.5, 1]kHz(dB) 69:STD Amp [0.5, 1]kHz(dB) 70: Avg Amp [1, 2.5]kHz(dB) 71: Peak Amp [1,2.5]kHz(dB) 72: Min Amp [1, 2.5]kHz(dB) 73: STD Amp [1, 2.5]kHz(dB) 74:Avg Amp [2.5, 5]kHz(dB) 75: Peak Amp [2.5, 5]kHz(dB) 76: Min Amp [2.5,5]kHz(dB) 77: STD Amp [2.5, 5]kHz(dB) 78: Avg Amp [5, 10]kHz(dB) 79:Peak Amp [5, 10]kHz(dB) 80: Min Amp [5, 10]kHz(dB) 81: STD Amp [5,10]kHz(dB)

The first step in the Phase II processing utilizes the recording qualityclassification that is contained in the header information from thePhase I pre-scan. When running Phase II, the user defines which qualityclasses should be used, and Phase II processing is then performed onlyon recordings with quality classifications that have been entered by theuser. The Phase II data output consists of records each of whichdescribe a sound-segment, where a sound-segment is a group ofconsecutive frames that are similar. The Phase II analyzer takes in thePhase I data and produces an output .csv file with sound-segment recordsof size 81 and an average rate of about three sound-segments per second.Thus the data rate, using 32-bit numbers, is reduced by a factor ofabout 7 to 7776 b/sec. In Phase II, the processing makes decisions, themost fundamental of which have to do with the partitioning the cry intothese utterances.

The output contains one 81-element record for each of the threesound-segment types that were defined previously, long-utterance,short-utterance, and silence. The specific field definitions areavailable in the supplementary material (see above). All 81 fields arefilled for long utterances, and appropriate fields filled for the othertypes. The 81 fields quantify file ID and 5 various classifier outputs,8 timing parameters, 6 F₀ parameters, 5 hyper-pitch parameters, 13formant parameters, 15 parameters from fitting a polynomial to the pitchcontour, and 28 parameters for amplitudes from several octave frequencybands. The segmentation is obtained by K-means clustering the 500 Hz to10 k Hz amplitude (dB) data into three classes in a pre-scan of thewhole recording and using the results to classify each frame as one ofthree classes: “1”=low energy, “2”=transition energy, and “3”=highenergy. The important long utterances consist of a contiguous sequenceof frames that each have a 500 Hz to 10 kH z amplitude (dB) classifiedas in the high-energy cluster with a high F₀ confidence. Using theseframe labels, the change in energy to help with the boundaries, and someextension rules, the partitioning is determined. If a contiguoussequence of high-energy frames is longer that 0.5 seconds (40 frames), along utterance is created. If only the length criterion is not met, thenthat sequence is classified as a short utterance, and if the sequence isof low energy, then the sequence is called a silence. The operationaldefinition of a long utterance is consistent with prior research oninfant crying (LaGasse et al, 2005), and allows for analyses ofutterances produced in different types of cries (e.g., initialutterances of pain-induced cries can be expected to be longer than 0.5seconds, but cry utterances produced in different contexts may beshorter). In our work with sound files of adequate quality, there hasbeen virtually no mislabeling of low-energy cry information as silence.

An important characteristic of many infant cries is when the cry is veryintensive with large amount of frication in the high-energy longutterances. This can be found in our system by seeing if there is veryhigh energy for a frame, but low F₀ confidence. What happens is that theextra frication-sounding energy for this frame tends to mask thecepstral detector. We call this phenomenon voiced frication and extractpertinent information about it for the Phase II output. Also, manyinfants exhibit a short air-intake noise—audible inspiration whichtypically follows a long cry and/or one produced by an infant underduress—immediately after a long utterance. If sufficiently close (intime) to the end of a long utterance, this period is included in thelong utterance but specifically noted as a classifier for the longutterance. An audible inspiration of this type is likely to be perceivedas a part of the cry utterance. The use of this classifier retains thefull length of the utterance, while also allowing for the user toexamine utterances with this classifier separately. While the thirdformant is very suspect, it has been included. As the contours of the F₀data within an utterance are important, we approximate these contours bya polynomial fit. Using an information-theoretic criterion, we estimatethe “best” order to use for this model. This number is often large,approaching 20 or more. We then restrict the fit to be of order five orfewer, and the best fit is often of the third or fourth order. All thepolynomial-fitting is done on the F₀ data. The class field is a number(1 to 10) descriptor of the shape of the fit, e.g., rising, falling,flat, double peak etc. The final 28 fields contain information on theamplitudes. Again, these values have not been normalized in any way.Each of the sound-segment-level statistics has been calculated by goingback to the power domain, accumulating properly over the frames of anutterance, and then transforming back to dB.

Validation of Pitch-Estimation and Frame Voicing-Decision Algorithms

Interpreted results from older analysis systems most often indicate thattiming—lengths and spacing of utterances—fundamental frequency andvoicing are highly informative features of infant cry production.Moreover, other features of infant cry, such as the contours of F₀across utterances, are dependent on the accuracy of F₀ estimation.Therefore, an experiment was conducted to evaluate the performance ofthe voicing-detection and pitch-estimation algorithm. We identified cryrecordings recorded previously in an ongoing longitudinal study (Lesteret al., 2002). Cries were elicited and recorded using proceduresapproved by hospital Institutional Review Board (IRB). The IRB alsoapproved access to these archival recordings for the purpose of theanalyses reported in this paper. Recordings were made of cries elicitedby standard methods (LaGasse et al., 2005) from typically developinginfants at one month of age. Cries were elicited by a specially designeddevice that applied a pain stimulus (analogous to a rubber-band snap)the sole of the right foot while babies lay supine in a pram with aunidirectional microphone suspended at a standardized distance above thebaby (5 inches). Cry samples were selected from an existing longitudinaldataset. A total of 15 cries from 15 individual babies were evaluated,each containing between 36 and 42 seconds of cry data. We coded andanalyzed only cries characterized by intense, loud, rhythmic, andsustained vocalizations that are differentiated from brief cries andfusses characteristic lower states of arousal.

These cries were selected on basis of the infants being the products offull term normal pregnancies and within normal limits scores on laterassessments of developmental functioning (e.g., Bayley Scales of Infantand Toddler Development at 24 months of age). Recordings were made in aquiet and controlled setting at a hospital-based developmentalassessment center, and thus the recording quality was high andbackground noise was minimal. Recordings were sampled at 48 kHz with theOlympus direct PCM recorder described above.

Establishing Ground Truth

Ground truth was established for both the presence of voicing and thecorresponding F₀ by hand-labeling each cry. Pitch-frequency labels wereobtained by hand-marking pitch-period intervals from the time-domainplot of the cry waveform. For this purpose we utilized a softwareprogram developed in our lab that conveniently displays both time andfrequency plots from .wav files (Silverman, 2011). All labels wereaffixed by a single person, trained to affix time markers at thehigh-energy peaks that generally allow the denotation of a pitchfrequency. Pitch-period labels were affixed for regions of each cryrecording determined to be clearly voiced.

The intervals of voicing were also hand-labeled using a spectrogramplot, as shown in FIG. 4. Intervals were first marked at the framelevel, indicating that the region about that particular 12.5 ms frameadvance was voiced. Then, the regions indicated by the labels on theframes as voiced were fine-tuned to indicate specific interval types atthe resolution of the sampling time by viewing the correspondingtime-domain plot. Five different interval types were defined: voiced(V), unvoiced (UV), silence (S), voiced-frication (VF), or high-voicing(HV). An interval was labeled as voiced (V) if the spectrogram showed awell-defined harmonic structure, indicating periodicity. An interval waslabeled as unvoiced (UV) if the spectrogram showed significant energywithout the presence of harmonics. Silence (S) intervals showed very lowsignal energy. The voiced-frication (VF) label was assigned when aninterval exhibited a harmonic structure in addition to turbulent(frication) noise at non-harmonic frequencies. Voiced-frications weregiven a separate label because it is unclear whether such frames shouldbe labeled as voiced or unvoiced. Finally, the high-voicing (HV) labelwas assigned to intervals with a very sparse harmonic structure,indicating a very high fundamental frequency (greater than 1 kHz) whichwe have called hyper-pitch excited frames.

TABLE 3 shows the number of frames in the data set corresponding to eachof the five voicing classes. The infant cries in this data set consistedmainly of voiced speech. Examples of the HV and UV classes occurredquite infrequently.

TABLE 3 Number of frames in the data set labeled with each of the fivevoicing classes Voicing Class # of Frames Voiced (V) 27745 High-Voiced(HV) 92 Unvoiced (UV) 3155 Voiced Frication (VF) 560 Silence (S) 13638The labeling was conducted by a research assistant who was first trainedto understand the kinds of patterns that should be labeled, and who wasthen trained to criterion-level of accuracy by Brian Reggiannini. Oncethe labeler's accuracy was confirmed on a series of training samples,she then hand-coded the cry samples as described above. It was thesehand-coded cry samples that were used as the gold standard or groundtruth for subsequent analyses of the accuracy of the automated system.Each frame required the careful labeling of 4 to 15 (or more ifhyper-pitch) F₀ onsets; some 2915 frames were hand labeled. Tocross-validate the hand-labeled ground truth, the same criteria wereapplied by an independent labeler used to hand label a little less than10% of the frames (256). The ROC curve and an expansion of the “knee”part of the curve are shown in FIGS. 5A and 5B. It may be seen in thisFigure that about 92% of the ground-truth data agree with those of thedata independently labeled within a 2 Hz tolerance, and that there is98% agreement within a 5 Hz tolerance. This provides a high degree ofconfidence in the ground truth data.Fundamental Frequency

The results demonstrate accuracy of the F₀ estimation algorithm. Theground-truth labels were placed at sample indices of consistent peaksbracketing each pitch period during clearly voiced cries. There areclearly multiple pitch periods in each voiced frame. The sample indiceswere compared with the frame boundaries used by the analysis system tofind all frames that were 100% covered by the pitch-period labels. Thesubset of frames for which hand-marked pitch-period labels wereavailable are represented as v₀. The same set of cry recordings wereprocessed by the analysis system, which output the set of estimatedvoiced frames v. The following analysis was carried out on v∩v0, the setof all frames for which the automatic voicing labels, v, and theground-truth voicing labels, v₀, agreed. The set v∩v₀ contained a totalof 2,915 voiced frames.

For each voiced frame in v∩v₀, the magnitude of the error between theestimated pitch frequency, f, and the ground-truth pitch frequency, F₀,was computed. The pitch frequency estimate was considered to be correctif |f−F₀|≤T, for some tolerance Tin Hertz. One should note that thequantization tolerance in the cepstral domain varies from about 1 Hz atan F₀=200 Hz to about 5 Hz at F₀=1 kHz. FIG. 6 shows the percentage offrames with correct pitch-frequency estimates corresponding to eachpitch-frequency tolerance, T. Several operating points are also shown inTABLE 4. As can be seen, the automated F₀ detection had an accuracy ofabout 90% at a tolerance of 10 Hz, and nearly 95% at a tolerance of 20Hz. We did not see evidence for any systematic disagreement between thehand-coded and automated F₀ detection.

TABLE 4 Percentage of the 2,915 voiced frames with correctpitch-frequency estimates (|f − f₀| ≤ T) for several error tolerances (Tin Hz). Tolerance T (Hz) % Correct Frames 10 88.44 20 94.17 30 95.33 4096.12 50 96.43Voicing:

A separate analysis was carried out to evaluate voicing-detectioncapabilities of the system. This analysis was formulated as a simpletwo-category classification problem, and FIG. 7 gives standard ReceiverOperating Characteristic (ROC) curves showing the evaluation results.FIG. 7 includes silence (S) frames. The system is very effective indistinguishing voiced (V) frames from unvoiced (UV) and silence (S)frames. As expected, the system achieves much higher error rates whenattempting to detect voiced frication (VF), which by definition are amixture of voicing and turbulent signals. The HV frames were also moredifficult to detect, although they occurred infrequently in this dataset. Area under the curve (Az) values demonstrate accurate detection ofvoiced sound segments. Az values ranged from 0.907 to 0.997 for theanalysis that included frames with silence, and 0.883 to 0.995 forframes that did not include silence.

The infant-cry analyzer described herein can be run in near-real-time ona normal PC platform, or could be run in real-time on many of today'sembedded processors. It's overall design involved several years ofcollaborative effort between hospital-based and engineering-basedfaculty at Brown University, and resulted in a system that has utilityfor both basic and applied research on infant cry production. Thissystem extends and builds upon recent approaches to quantifying acousticfeatures of infant cry (e.g., papers of Branco, et al., 2007; LaGasse etal., 2005; Lester, et al., 1991; Manfredi, et al., 2009; Varallyay, etal., 2004). This automated system is described in detail in order toprovide the reader and potential users with a clear understanding of theapproach that we used to develop this system. Quite uniquely, weconducted stringent tests of accuracy of this automated system ascompared to hand-labeled cry spectrograms.

As detailed above, the apparatus analysis system has two levels ofoutput. Phase I segments the sound into analysis frames with an advanceof 12.5 ms. Each frame is summarized by the system for features thatinclude timing, voicing, F₀, amplitude, and formant information. PhaseII operates on the Phase I data, making decisions with regard toclassifying portions of the sample as cry utterances or silence, whichcould be a portion of the recording prior to cry onset, or couldrepresent time periods between cry utterances. This timing informationallows researchers to utilize other measures such as latency to cry,which is of interest for researchers utilizing standard methods toelicit infant cries (LaGasse et al., 2005), and inter-utteranceintervals, useful for classify different types of infant cries (e.g.,pain vs. non-pain cries). In addition to this timing information, thePhase II output yields summary descriptors of cry utterances, includingmeasures of F₀, amplitude of cry in various frequency bands, andestimates of formant location. This Phase II output also yields measuresof the voiced proportion of each cry utterance. A unique aspect of thisoutput is that it includes a confidence estimate for the voicingdecision. This is based on an SNR analysis and allows the researcherboth full information on how the voicing decision was made, as well asthe ability to modify this decision, should the research question callfor a more or less stringent definition of voicing.

An additional unique feature of the Phase II output is an automatedapproach to describing F₀ contours across a cry utterance. Some pastresearch has made use of this variation in F₀ across utterances todescribe “melodic” aspects of cries, but has accomplished this task byhand classification of F₀ contours from spectrograms (Mampe, Friederici,& Wermke, 2009; Wermke, Mende, Manfredi, & Bruscaglioni, 2002). Thesystem described here utilizes a polynomial fit method to classify F₀contours. Initially, the system classifies these contours into one often categories. This output may be used to identify cry utterances withmore or less prototypical contours, to characterize the complexity ofsuch F₀ variation, or to explore differences in F₀ contours related todevelopment or population differences. The validity of an automatedacoustic analysis is dependent on its performance accuracy. Therefore,we conducted a substantial experiment that indicates the accuracy ofboth the voicing and the fundamental frequency detectors. The featuresthat were selected, i. e., F₀ and voicing, are the ones that have provento be most discriminating of clinical populations in past literature.

As depicted in FIGS. 6A and 6B, about 90% of the automatic estimateswere within a F₀ tolerance of 10 Hz. The best the estimator does is96.4% when the tolerance is opened up a bit to 50 Hz. Virtually allerrors occur at the boundaries of voiced utterances. Equal-error ratesfor voiced (versus unvoiced or silence frame detection) is nearly 99%.Much more difficult to detect hyper-pitch frames are identified with anequal-error rate of about 80%. Past research utilizing automatedanalyses of infant cry has generally not reported this type ofperformance analysis. Further, other computer-assisted methods haveutilized analyzers designed for adult speech. Validation of a systemspecifically designed to summarize the acoustic features of infant cryis therefore an advance in the field, and a unique strength of themethodology and apparatus reported here. Evaluation revealed highaccuracy of the automatic detectors of F₀ and voicing decisions incomparison to gold standard hand coding from spectrogram displays.

The analysis system yields an excellent reduced data representation ofthe desired acoustic features of babies' cries, and may be used as arecord to document cry characteristics, and a diagnostic tool foratypical characteristics. However, there are some areas of analysis thatare a significant challenge for infant cry analysis. In particular, theaccurate automatic detection of formants is quite difficult given thehigh pitch and wide harmonic structure of infant cry (Robb & Cacace,1995). In adult speech, the shape of the vocal tract determines theresonant frequencies, which are described as formants. For our purposes,we applied a low-pass “lifter” to the data in order to assist inestimating the location and magnitude of formants in the infant cry. Wehave described this approach, but we acknowledge that the problem ofboth the measurement and interpretation of formants in infant cryremains to be fully resolved. An additional challenge is to reliablydetermine voicing in conditions that we refer to as voiced-fricative orhigh-voicing portions of a cry utterance. These issues are a reflectionof some of the conceptual and methodological challenges to furtherdevelopment of the system, and to infant cry analysis more generally. Onbalance, the automated nature of this analysis system makes possiblerapid analysis for large datasets and thus studies of substantialnumbers of subjects, allowing for more powerful studies of differencesin infant cry associated with various medical or developmentalconditions or populations and more accurate detection of characterizingcry features. The system enables a researcher to summarize broadcharacteristics of cry utterances using the Phase II output, while alsopreserving detailed micro-analytic data in the Phase I output that wouldallow for precise characterization of within utterance variations in cryproduction.

Further embodiments of the invention are contemplated, including thedetection of possible individual or group differences in cry productionto help to screen for infants at risk for various developmentaldisorders, or it may find use in medical applications, such asidentifying infants at risk for poor developmental outcomes. Thus, avalidated cry analyzer will be useful for continued research ondevelopmental outcomes in at risk infants, including investigations ofneurobehavioral outcomes associated with prenatal environmental riskfactors. Moreover, the complex nature of infant cry acoustics has thepotential to yield feature patterns that can be used to identify infantsat elevated risk for poor developmental outcomes or specificdevelopmental disorders such as autism spectrum disorders. More basicresearch may also utilize this system in order to study normativeaspects of infant cry production with larger samples than has beenpossible in the past. Instruments for recording and analysis, or foranalysis of existing recordings, may include other processing steps andfeature-identifying stages, and may include a user-friendly interface toenhance the accessibility of for a variety of researchers technical orsupport staff.

The invention now having been fully described, it is further exemplifiedby the following claims.

What is claimed is:
 1. A method for diagnosing a developmental disorderin an infant by analyzing cry of the infant, the method comprising:filtering a digital recording of an infant cry, by assigning to adigital signal of the recording: a fixed frame rate of a plurality ofsamples, a window function, and a frame advance, thereby obtaining analtered digital signal, and limiting a range of accepted frequency byapplying a frequency window to a log-spectrum of the altered digitalsignal, wherein the frequency window is from about 200 Hz to about 2200Hz, thereby obtaining a first filtered digital signal, wherein the firstfiltered digital signal is a frequency window output; estimating afundamental frequency and a cepstrum value of the infant cry by applyingto the first filtered digital signal an inverse discrete Fouriertransform to obtain the fundamental frequency and cepstrum estimatevalue of the first filtered digital signal, thereby obtaining a secondfiltered digital signal; smoothing the second filtered digital signal byapplying a programming smoother to the second filtered digital signaland maintaining continuity in the fundamental frequency estimates of thesecond filtered digital signal, eliminating outliers from the secondfiltered digital signal by applying a median filter, wherein the medianfilter is selected from a group of a median filters of five point andseven point median filters, to the second filtered digital signal andobtaining a median filter output, extracting a confidence measure fromat least one of the first filtered digital signal values and the secondfiltered digital signal on a frame by frame basis, and applying to themedian filter output a signal-to-noise ratio test, so as to obtain atleast one parameter of acoustic analysis of the infant cry; obtaining adata set having at least one parameter of acoustic analysis from a firstgroup of normal infant subjects, and from a second group of infantshaving a developmental disorder or at risk for having a developmentaldisorder to correlate at least one parameter of acoustic analysis to anindicator of the disorder or risk; and diagnosing a presence of adevelopmental disorder in the infant by comparing at least one parameterof acoustic analysis to the data set.
 2. The method according to claim1, further estimating the fundamental frequency of the first filtereddigital signal, if, greater than about 800 Hz, by applying aninterpolated transform of 4096 points and a low pass filter.
 3. Themethod according to claim 1, further comprising after applying thesignal to noise ratio test, classifying a sound segment of the infantcry within the parameters as at least one of: an utterance, a shortutterance, and a silence, wherein the sound segment comprises a group offrames having similar properties.
 4. The method according to claim 3,further comprising characterizing a sound segment record by each ofelements: classifier output, timing parameters, F0 parameters,hyper-pitch parameters, formant parameters, parameters from fitting apolynomial to the pitch contour, and parameters for amplitudes fromseveral octave frequency bands.
 5. The method according to claim 1,wherein the parameter of acoustic analysis comprises at least one of:frame number, time (ms), F₀, F₀ amplitude (dB), F₀ confidence [0-1],hyper-pitch (Hz) ([1-5] kHz range), hyper-pitch amplitude (dB),hyper-pitch confidence [0-1], peak pitch amplitude (dB), overallamplitude (dB), amplitude [0.5-10] kHz (dB), amplitude [0-0.5] kHz (dB),amplitude [0.5-1] kHz (dB), amplitude [1-2.5] kHz (dB), amplitude[2.5-5] kHz (dB), amplitude [5-10] kHz (dB), F₁ (Hz), amplitude of F₁(dB), F₂ (Hz), amplitude of F₂ (dB), F₃ (Hz), and amplitude of F₃ (dB).6. The method according to claim 1, further comprising prior tofiltering the digital recording, converting the digital recording into acomputer readable format by a computer program embedded in anon-transitory computer readable medium.
 7. The method according toclaim 3, wherein the utterance has a signal length equal to or greaterthan 0.5 s.
 8. The method according to claim 1, wherein estimating thefundamental frequency of the infant cry further comprises validating,wherein the estimate has an accuracy of at least about 80%, about 85%,about 90%, about 95%, or at least about 99%.
 9. The method according toclaim 6, wherein the computer readable format is a .csv file of valuesof the parameters of acoustic analysis.
 10. The method according toclaim 1, wherein the developmental disorder is selected from the groupof: Autism spectrum disorders selected from the group of: Autisticdisorder, Asperger's disorder, child disintegrative disorder, Rettsdisorder, pervasive developmental disorder NOS, and Autism spectrumdisorder; communication disorders selected from the group of:developmental language disorders, mixed-expressive receptive languagedisorder, language disorder, speech disorder, and social communicationdisorder; intellectual developmental disorders selected from the groupof: intellectual developmental disorder and intellectual or globaldevelopmental delay not elsewhere classified; hearing impairment;cognitive impairment; language impairment; behavior disorders; andimpairments or deficits related to “high risk” conditions exemplified byprenatal substance exposure, prematurity, low birth weight, intrauterinegrowth retardation, medical illness or brain injury, maternal history ofmental illness, treatment, adverse pregnancy conditions exemplified bypoor nutrition, poor prenatal care, physical assault, and geneticconditions that increase risk for cognitive, language, or behavioralimpairments.
 11. The method according to claim 1, further comprisingafter obtaining the digital recording of the infant cry, classifying aportion of infants that have the disorder from among a plurality of theinfants.
 12. The method according to claim 11, further comprising afterobtaining the digital recording of the infant cry classifyingretrospectively the portion of infants that have the disorder.
 13. Themethod according to claim 1 further comprising, applying a stimulus toan infant, wherein the stimulus stimulates the infant cry in reaction.14. The method according to claim 13, wherein the infant cry isstimulated by applying a pain stimulus.
 15. The method according toclaim 1, wherein the infant cry is spontaneous.
 16. The method accordingto claim 1, wherein the method distinguishes a pain induced cry and aspontaneous cry.
 17. The method according to claim 1, further comprisingafter diagnosing the presence of the developmental disorder,administering early intervention to the infant.
 18. An apparatus foranalyzing an infant cry, the apparatus comprising, a recording deviceadapted and configured to record the infant cry, thereby obtaining adigital signal of a recorded infant cry, a computer program embedded ina non-transitory computer readable medium, the computer readable mediumcomprising instructions to perform the method of claim 1, and acomputer, wherein the recording device and the non-transitory computerreadable medium are compatible with the computer and are linkable to thecomputer.
 19. The apparatus according to claim 18, wherein the parameterof acoustic analysis comprises at least one of: frame number, time (ms),F₀, F₀ amplitude (dB), F₀ confidence [0-1], hyper-pitch (Hz) ([1-5] kHzrange), hyper-pitch amplitude (dB), hyper-pitch confidence [0-1], peakpitch amplitude (dB), overall amplitude (dB), amplitude [0.5-10] kHz(dB), amplitude [0-0.5] kHz (dB), amplitude [0.5-1] kHz (dB), amplitude[1-2.5] kHz (dB), amplitude [2.5-5] kHz (dB), amplitude [5-10] kHz (dB),F₁ (Hz), amplitude of F₁ (dB), F2 (Hz), amplitude of F₂ (dB), F₃ (Hz),and amplitude of F₃ (dB).
 20. The apparatus according to claim 18,further comprising, a stimulating component, wherein the stimulatingcomponent provides a stimulus to an infant so as to initiate the infantcry in reaction.
 21. Apparatus for infant cry analysis comprising meansfor: receiving a digital sound recording or digitizing an analog soundrecording of an infant cry, wherein the sound recording is aconsumer-device-formatted sound recording or other standard format,limiting the recording to a frequency range of about 200-2200 Hzrepresenting a frequency band of interest and segmenting the recordinginto cry segments by type, wherein the segment types include intervalsof silence, short cries and long cries, performing computerized acousticanalysis on each segment to identify acoustic parameters of therecording according to method described in claim 1, wherein the acousticparameters include one or more of frame number, time (ins), F₀, F₀amplitude (dB), F₀ confidence [0-1], hyper-pitch (Hz) ([1-5] kHz range),hyper-pitch amplitude (dB), hyper-pitch confidence [0-1], peak pitchamplitude (dB), overall amplitude (dB), amplitude [0.5-10] kHz (dB),amplitude [0-0.5] kHz (dB), amplitude [0.5-1] kHz (dB), amplitude[1-2.5] kHz (dB), amplitude [2.5-5] kHz (dB), amplitude [5-10] kHz (dB),F₁ (Hz), amplitude of F₁ (dB), F₂ (Hz), amplitude of F₂ (dB), F₃ (Hz),and amplitude of F₃ (dB), and providing the detected parameters as aspreadsheet file for use as a validated medical or diagnostic record.22. Apparatus according to claim 21, further comprising diagnosticsoftware for highlighting diagnostic indicia among the reportedparameters, wherein the diagnostic indicia reflect likelihood that theinfant cry indicates a developmental or neurological condition such asASD, or a medical condition such as an airway or tissue anomaly. 23.Apparatus according to claim 21, further comprising a cry stimulusdevice adapted and configured to providing a controlled cry-provokingstimulus to an infant synchronized with recording of the infant's cry,and further comprising a video recorder for validating cry data.